磁源性影像在中央区癫痫患者癫痫灶及手区体感皮质定位中的应用  

Magnetic source imaging in localizing epileptic focus and the primary somatosensory cortex of hands in rolandic epilepsy patients

作　　者：孙吉林[1] 贾秀川[1] 柳溪[1] 吴杰[1] 吴晶[1] 李素敏[1] 

机构地区：[1]河北省人民医院医学影像科,河北石家庄050051

出　　处：《中国医学影像技术》2014年第1期16-19,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨磁源性影像(MSI)对中央区癫痫患者癫痫灶定位及手区体感皮质定位的应用价值。方法对11例中央区癫痫患者进行脑磁图(MEG)及MR检查,将所获脑解剖结构图及发作间期异常放电、双侧大脑半球手区体感皮质位置叠加,形成MSI;并与术中皮质脑电图(ECoG)结果比较。结果 11例中,MRI显示软化灶4例,局灶性脑皮质发育不良4例,左颞极内侧蛛网膜囊肿1例,2例未见异常;MEG定位癫痫灶与ECoG完全一致9例,不一致2例;术后病理显示局灶性脑皮质发育不良(FCD)6例,微发育不良1例,胶质增生4例。6例癫痫灶与MSI确定的大脑半球手区体感皮质重叠:1例癫痫灶位于手区体感皮质前内侧,2例位于手区体感皮质稍后下方,1例位于手区体感皮质前方2cm,1例位于手区体感皮质后方2cm。术后随访Ⅰa级10例;Ⅲ级1例。所有患者未发生明显功能障碍。结论 MSI可明确癫痫灶与手区体感皮质的关系,指导临床进一步治疗。Objective To observe the value of magnetic source imaging （MSI） in defining epileptic focus and somatosen- sory cortex of hands in rolandic epileptic patients. Methods Totally 11 patients with rolandic epilepsy underwent magne- toencephalography （MEG） and MRI. The anatomy structures depicted by MRI and the findings of interictal discharge and somatosensory cortex of hands obtained by MEG were superimposed as MSI, and were compared with intraoperative elec- trocorticography （ECoG）. Results Among 11 patients, MRI showed 4 with encephalomalacia, 4 with focal cortical dys- plasia, 1 with arachnoid cyst in the left temporal pole, whereas 2 were normal. Overall agreement of findings of spikes be- tween ECoG and MEG was obtained in 9 patients, the areas localized by ECoG were larger than MSI in 2 patients. Postsur- gical pathology showed focal cortical dysplasia （FCD） in 6 patients, microdysgenesis in 1, gliosis in 4 patients. The epilep- tic focus overlaid with somatosensory cortex of hands defined by MSI in 6 cases, localized at the anterior-inner side of the somatosensory cortex in 1 case, at posterior-inferior side in 2 cases, localized about 2 cm anteriorly in 1 case and 2 cm pos- teriorly in another case. Follow-up results showed I a in 10 cases and B] in 1 case. There was no obvious dysfunction after operation in all patients. Conclusion MSI can identify the relationship of epileptogenic loci and the primary somatosensory cortex of hands in rolandic epileptic patients, therefore indicates advanced clinical treatment.

关 键 词：磁共振成像 脑磁图描记术 体感皮质 手 中央区 癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]